Individual provider Active NPI

Timothy Miller, PA

  • Physician Assistant
  • Low Moor, VA
National Provider Identifier
1659343572
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110-001782 Issued in VA
Practice address
200 Arh Lane
Suite 100
Low Moor, VA 24457
Phone
(540) 862-6710
Fax
(540) 862-7922
NPI assigned
Feb 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-001782 VA Primary

Addresses

Primary practice location

200 Arh Lane
Suite 100
Low Moor, VA 24457

Mailing address

PO Box 457
White Sulphur Springs, WV 24986-0457
Phone (304) 536-5030

Other identifiers 1

IdentifierTypeStateIssuer
010044561MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040329001162 VA Practitioner - Physician Assistant 9931091360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wvva Health Care Alliance PCGroup PAC ID 2668466558, 2 clinicians
H2 Rehabilitation Services of Virginia, LLCGroup PAC ID 1658280128, shared by 6 NPIs, 67 clinicians

Practice addresses (Care Compare)

200 Arh Lane
Suite 100
Low Moor, VA 24457
Phone (540) 862-6710

320 W Main St
Covington, VA 24426-1517
Phone (540) 962-6226

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110-001782VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: timothymiller@medooov.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1659343572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "city": "WHITE SULPHUR SPRINGS",
            "state": "WV",
            "postal_code": "249860457",
            "telephone_number": "304-536-5030",
            "fax_number": "304-536-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARH LANE",
            "address_2": "SUITE 100",
            "city": "LOW MOOR",
            "state": "VA",
            "postal_code": "24457",
            "telephone_number": "540-862-6710",
            "fax_number": "540-862-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "TIMOTHY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-001782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010044561",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Low Moor, VA

Sources for this page

Verify at the official NPI Registry.